That instrumental delivery should be banned?

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I know it’s the DM but this is shocking:

www.dailymail.co.uk/health/article-6797199/As-doctors-midwives-finally-act-searing-expos-childbirths-shameful-secret.html

They say 10 percent of mums suffer from some sort of anal incontinence! Claims forceps are the biggest cause so why are they still used? AIBU to say they should be banned? Why couldn’t you just get a C-sec at that point?

I'd really like to know more about how they manage childbirth in Denmark. Apparently there hasn't been an instrumental delivery in 14 years and section rates are also lower.

Me too. Forceps aren’t used in my home country very much (only older doctors are trained in this, has fallen out of use generally), but the c-section rates are very high. Thought this would be the trade-off, good to hear that it’s not necessarily so.

I gave birth in a (third) non-Western country with reasonable health care, and my OBGYN (not a mid-wife led system) simply doesn’t do instrumental delivery. I had a EMCS fairly quick into the pushing stage, though, not even 30 minutes had passed

I’m glad this conversation is beginning to happen. Unfortunately a lot of women are practically brainwashed not to speak out or question anything that happens during their care. We are seen as selfish for having anything other than eternal gratitude for a live baby, regardless of what has happened to our own physical and mental health.

And it definitely wouldn’t be this way for men. Planned CS purely for choice would have always been a ‘thing’ without any questions raised, certainly without the horrible judgement so many women face. They would also be completely involved in all decisions, have their rights and options clearly laid out and not be patronised or belittled to the same extent.

Sadly I have relatives and friends whose birth was traumatic and left both them and their babies with serious problems.

Always thought they were a last resort option and I was lucky to have very short, sweet and problem free births but four of my nieces were all born with instruments and an old school-friend is currently in the middle of a personal injury claim against the NHS trust that left her suffering from incontinence that will need several operations.

My brother's description of the midwives pulling his last daughter out in a last panic attempt was horrendous. He said the midwife's hands were shaking from the force "like she was pulling snow chains off I expected her to put a foot on the end of the bed and really get her back into it"

One of the other girls looked like a fucking Kinder egg for weeks and weeks.

I put 'no forceps' on my birth plan last time and it will be the same this time. They give me the absolute horrors, so mine might not be the most balanced view. In the end I didn't need them, thankfully, however i still don't think they should be banned if they serve a valuable medical purpose.

What really bothers me about all this is that aftercare for women seems to be utterly rubbish. My midwife strongly urged me to keep up with pelvic floor exercises but never really explained to me what I should be looking out for post birth. As it happens I had a prolapse, and now have bladder incontinence too, when I cough badly or sneeze (as I suspect thousands of mums do). And that was without an instrumental delivery, god knows what the damage could have been if forceps were involved.

Having said all that, I don't think forceps should be banned, but I think the risks should be made much more clear to pregnant women and their birth partners. I think women's care post birth should be vastly improved. My doctor didn't ask me a single thing at the six week check, it was all about the baby. I feel strongly that if they had taken more time then, they might have picked up the PND I was already struggling with at that time.

I also think that we need to be talking about these things so much more. I'm guilt of keeping quiet, I find it utterly mortifying when I pee when I cough, and I hate having to buy continence pads. I said as much to my husband, and he bluntly asked me what I felt I had to be ashamed about. His attitude is that I have a long term injury as a result of doing something exceptionally hard on the body. It's something I have to live with and manage, but not something I should be ashamed of. I know he's right, but it is hard to get past the embarrasment sometimes.

The NHS website described forceps as being ‘gently pulled’ to deliver the baby

There just needs to be more transparency. The article states women just need to be spoken to antenatally about if intervention is needed how they want that to happen. Choices and risks need to be explained.

I think there's a lot of ignorance and denial about birth injury. Childbirth was really straightforward for me and seemingly most of my friends.

I remember one friend who had only one child saying she would never go through childbirth again and actually thinking, "Really, you're a bit of a wimp aren't you?"

Mumsnet has been a massive eye opener to me that when people say they had a horrendous delivery, they really aren't saying that the midwife shouted at them and they had a few stitches.

YABVU.

Without forceps, DD may have died during delivery. I'm lucky that the long-term health implications haven't been too bad for me, but even if they were. I would choose that over my baby's death.

"Soon they were using ventouse and foreceps, dragging me down the bed by the vagina "

Bloody hell -there are no words.

It really shouldn't be a choice between long term health implications for you or your baby's life though Jammy. It's the bloody 21st century. We transplant organs, carry out amazing plastic surgery and repair tiny baby hearts. Yet childbirth hasn't moved on from the fifties.

I was delivered by high rotational forceps in the early 80s and have birth injuries because of it - to one of my eyes, and (weirdly) an ankle. My mum had an awful time too, god knows how hard they were pulling on my head and how much they were messing about trying to turn me. She requested C sections for my siblings.

I'm one of those women who probably shouldn't have had babies - they don't seem to know what to do when it's time to leave 2 weeks bloody overdue at that! so I've had a ventouse and a forceps delivery. With the forceps delivery, I was taken for a (semi?) EMCS as it wasn't progressing, but as it was the middle of the night, I had to wait for theatre to be free. An hour later I was in theatre. Epidural was topped up, all ready to go, when the dr had a look, and decided to go for forceps instead. By that point I had consented to everything, and I told her to go for it.
Forceps DC is now a teenager, and there have been no long term ill effects. I'm fully continent, DC is fine, and although I had stitches with both, they healed nicely. His head was a funny shape for a while, and he wasn't the best sleeper - who knows if he'd have been a better sleeper if he hadn't been a forceps delivery. Long term, he's fine though.
I may have been lucky, it may have been practitioner skill, I don't know, but I hear so many horror stories about births. Labouring women need to be listened to. For all the mums who are struggling with the after effects of birth, please don't feel embarrassed or shame - you did something fucking hard, and produced a new human being. That's amazing. Be kind to yourselves.

In the case of my first birth I'd been quite vocal about not wanting a CS during labour. It was a long labour that stalled a couple of times, including once I was fully dilated. If at any point (esp after that) I'd given the word, I'm pretty sure I would have got a CS. I had a lovely MW who encouraged me to keep going, but (when I started getting a bit rattled) got me ready for a CS just in case. The pushing stage took ages (I found the epidural incredibly disorientating) and the ventouse was used at quite an early stage when dc1 started showing signs of distress, with the result, again, that he had quite a good Apgar. (And a large head for his gestation, which I think was part of the problem). Dc2 was very different - I turned up at the hospital thinking I was in early labour, turned out to be 9cm, got onto the bed for what I thought would be brief monitoring and went into transition. He was born less than half an hour later after they'd done an ARM and found meconium and then noticed other signs of distress. (I've had three births and my waters have never gone on their own - dc3 was born in the caul). Both times I was guided to push along with the application of the ventouse. There wasn't any sense of panic at all in either birth. I think in my case they were used well and at pretty much exactly the right stage. (I should perhaps add that I didn't give birth in the UK). There was no talk of forceps at any stage, though I don't know whether there would have been had the ventouse failed. I also think it was significant that a lot of listening to me went on, less so in the second birth, but I'd only been there half an hour when he was born and we were all catching up with the situation all the time.

Reading through some of the previous posts makes me feel awful as people have had to go through such horrendous experiences.
I opted for a planned CS as MIL had suffered a lifetime of issues following a forceps delivery (albeit many years ago) and, having researched the issue, I decided that it was the safest route for me and DC.
We need to be given impartial, accurate information about the relative risks and benefits of all options, and then be given the right to choose what we feel is best for us.
(And that decision shouldn't then be questioned by health care professionals or worse, our choice denied- they do not have to live with the consequences when things go wrong).

“Gently pulling”

Nope. Doctor had her foot on the bed. Midwife pinning me down so I didn’t move.

Nope. Doctor had her foot on the bed. Midwife pinning me down so I didn’t move.

Yup, mine too. Luckily it only took three tugs before she appeared, but I was amazed/horrified at the force put on the head of my teeny 7lb baby daughter. It must have been horrible for her.

I think that women should be fully informed of the risks relating to vaginal birth as well as C-sections. I also think that everyone needs to think about consequences as well as likelihood. What I mean is: from what I read, the chances of me suffering a serious tear were something like 20% at my age (40s). I'm now wondering if it was actually a bit higher. But anyway, I realised obviously that 20% risk of tear = 80% chance of no tear. The problem is that the consequences if I had been in that 20% were pretty substantial - faecal incontinence, prolapse etc. So for me that wasn't a risk worth taking. As it turned out I needed a C-section for medical reasons anyway (mine and baby). But no one warned me about the increased risk of tearing at my age, and if I was having an operation that carried that sort of risk it would be right at the top of the list.

I'd really like to know more about how they manage childbirth in Denmark. Apparently there hasn't been an instrumental delivery in 14 years and section rates are also lower.

I would to.

I also wonder if the costs of dealing with with birth injuries and mental trauma is ever added up and added to birth costs or just ignored as it comes out of other budgets.

I think it's the debrief/aftercare which fails but i fully appreciate this is a funding issue rather than anything else.

Despite wanting minimal intervention, my child was delivered by forceps following failed ventouse. I am incredibly grateful that they were able to deliver safely despite the ongoing impact on my body and mind.

The alternative does not bare thinking about.

I tried for a home birth. I failed and an ambulance was called. I had a foreceps delivery - small foreceps as dd was nearly out.

I take it home births would be a no go in a country with a non instrumental delivery as the risk would be too high. Apparently by the time I arrived at hospital they could see dds hair pushing out - the jiggles from the ambulance wiggled her down a bit more. Dd had to be manually turned a bit first.

I am horrified to read some of these stories. I would not advise a home birth as my experience was pretty traumatic and they needed to get dd out quite quickly in the end as she was going into distress. I imagine with the progress I was making I would have ended up with an emc in places like Denmark.

I don't know where the stats from Denmark came from but even though they have lower instrumental delivery rates, they have similar 'obstetric trauma' rates in non instrumental deliveries to the UK and far higher trauma rates than us in instrumental deliveries.

Wow. To be honest, it hurts a bit to have someone suggest that the instrument that saved both of our lives when I gave birth to my first baby should be banned.

No, it shouldn’t - at least not until hospitals are properly funded and staffed to allow each and every birth to be properly managed. Instrumental births are not ideal, but necessary when no other options are left.

Oh and I'm another one whose baby would have died without forceps. She moved her head and got stuck when almost out of the birth canal. If they had gone for CS they would have needed forceps to pull her back up. I did (do) suffer a small degree of anal incontinence. Birth is inherently risky. That isn't made clear enough to us.

TinklyLittleLaugh Have you told your friend this? Only because I'm sure she picked up by your reaction that you thought she was a wimp rather than dealing with birth injuries. It might be appreciated by her to feel validated.

I'm alive due to forceps (I got stuck in the birth canal), though my eye was slightly damaged during it - it's my worse one for vision.

My son was delivered after an induction given four days after they detected irregular heart beat (another issue in itself). As I reached 10cm (just), they detected meconium and then his heart rate began to drop dramatically as I pushed. The consultant didn't register this, my midwife went to get him back into the room and thanks to her we went from there straight to theatre and prepped, all papers signed, in I think around four minutes.Thanks to a ventouse delivery at that stage he's alive and well. I do have some stress incontinence issues, thankfully not anal, but I would also choose instrumental once things have started to go badly wrong, as they did with me.

I would however, be extremely interested to see improvements in how women are encouraged to labour and deliver, with a view for earlier intervention and adopting birth processes that have been shown to work well in other countries.

Whether this will happen given the chronic underfunding of health services in the last decade or so seems unlikely.

A lot of the responses to this thread are a bit myopically British. While I am sure that there is a place for forceps, the fact remains that forceps deliveries are much much rarer in most other countries. I suspect that money saving is the incentive behind a lot of forceps deliveries in the UK. I also think there is a sense of wanting doctors to "keep their hand in" and not forget how to perform them.